title: Outbreak of Salmonella typhimurium infection traced to contaminated chocolate and caused by a strain lacking the 60-megadalton virulence plasmid.
abstract: We describe an outbreak of Salmonella typhimurium infection, caused by contaminated chocolate produced by one Norwegian company, which occurred in Norway and Finland in 1987. A total of 349 bacteriologically verified cases were recorded in Norway, and 12 cases were recorded in Finland. There was a predominance of young children among the patients (median age, 6 years), many of whom developed acute hemorrhagic diarrhea. The outbreak strain exhibited a rare phage lysis pattern and a characteristic plasmid profile lacking the 60-MDa virulence-associated plasmid. DNA hybridization failed to demonstrate any DNA sequence homology between the outbreak strain and the virulence plasmid. The outbreak strain was nonlethal for orally infected mice. The finding of only less than or equal to 10 S. typhimurium cells per 100 g of chocolate in about 90% of the positive samples obtained from retail outlets suggested that an inoculum of fewer than 10 organisms may have been sufficient to cause symptomatic disease.
authors.affiliation: Department of Bacteriology, National Institute of Public Health, Oslo, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Kapperud
authors.forename: S
authors.initials: S
authors.lastname: Gustavsen
authors.forename: I
authors.initials: I
authors.lastname: Hellesnes
authors.forename: A H
authors.initials: AH
authors.lastname: Hansen
authors.forename: J
authors.initials: J
authors.lastname: Lassen
authors.forename: J
authors.initials: J
authors.lastname: Hirn
authors.forename: M
authors.initials: M
authors.lastname: Jahkola
authors.forename: M A
authors.initials: MA
authors.lastname: Montenegro
authors.forename: R
authors.initials: R
authors.lastname: Helmuth
mesh_terms: D002099:Cacao / Q000009:adverse effects; D004196:Disease Outbreaks; D005387:Finland / Q000453:epidemiology; D006801:Humans; D009664:Norway / Q000453:epidemiology; D010957:Plasmids; D012478:Salmonella Food Poisoning / Q000453:epidemiology*; D012486:Salmonella typhimurium / Q000235:genetics; D014774:Virulence / Q000235:genetics